Ictal pain: occurrence, clinical features, and underlying etiologies.

PURPOSE: We analyzed a series of patients with ictal pain to estimate its occurrence and characterize the underlying etiologies. METHODS: We retrospectively reviewed all the long-term video-EEG reports from Jefferson Comprehensive Epilepsy Center over a 12-year period (2004-2015) for the occurrence of the term pain in the text body. All the extracted reports were reviewed, and patients with at least one documented episode of ictal pain in the epilepsy monitoring unit (EMU) were included in the study. RESULTS: During the study period, 5133 patients were investigated in our EMU. Forty-six patients (0.9%) had at least one documented episode of ictal pain. Twenty-four patients (0.5%) had psychogenic nonepileptic seizures (PNES), 10 patients (0.2%) had epilepsy, 11 patients (0.2%) had migraine, and one woman had a cardiac problem. Pain location was in the upper or lower extremities (with or without other locations) in 80% of the patients with epilepsy, 33% of the patients with PNES (p=0.01), and none of the patients with migraine. CONCLUSION: Ictal pain is a rare finding among patients evaluated in EMUs. Psychogenic nonepileptic seizures are the most common cause, but ictal pain is not specific for this diagnosis. Location of the ictal pain in a limb may help differentiate an epileptic cause from others

Spike voltage topography in temporal lobe epilepsy

We investigated the voltage topography of interictal spikes in patients with temporal lobe epilepsy (TLE) to see whether topography was related to etiology for TLE. Adults with TLE, who had epilepsy surgery for drug-resistant seizures from 2011 until 2014 at Jefferson Comprehensive Epilepsy Center were selected. Two groups of patients were studied: patients with mesial temporal sclerosis (MTS) on MRI and those with other MRI findings. The voltage topography maps of the interictal spikes at the peak were created using BESA software. We classified the interictal spikes as polar, basal, lateral, or others. Thirty-four patients were studied, from which the characteristics of 340 spikes were investigated. The most common type of spike orientation was others (186 spikes; 54.7%), followed by lateral (146; 42.9%), polar (5; 1.5%), and basal (3; 0.9%). Characteristics of the voltage topography maps of the spikes between the two groups of patients were somewhat different. Five spikes in patients with MTS had polar orientation, but none of the spikes in patients with other MRI findings had polar orientation (odds ratio = 6.98, 95% confidence interval = 0.38 to 127.38; p = 0.07). Scalp topographic mapping of interictal spikes has the potential to offer different information than visual inspection alone. The present results do not allow an immediate clinical application of our findings; however, detecting a polar spike in a patient with TLE may increase the possibility of mesial temporal sclerosis as the underlying etiology

Ictal verbal help-seeking: Occurrence and the underlying etiology.

PURPOSE: Ictal verbal help-seeking has never been systematically studied before. In this study, we evaluated a series of patients with ictal verbal help-seeking to characterize its frequency and underlying etiology. METHODS: We retrospectively reviewed all the long-term video-EEG reports from Jefferson Comprehensive Epilepsy Center over a 12-year period (2004-2015) for the occurrence of the term help in the text body. All the extracted reports were reviewed and patients with at least one episode of documented ictal verbal help-seeking in epilepsy monitoring unit (EMU) were studied. For each patient, the data were reviewed from the electronic medical records, EMU report, and neuroimaging records. RESULTS: During the study period, 5133 patients were investigated in our EMU. Twelve patients (0.23%) had at least one episode of documented ictal verbal help-seeking. Nine patients (six women and three men) had epilepsy and three patients (two women and one man) had psychogenic nonepileptic seizures (PNES). Seven out of nine patients with epilepsy had temporal lobe epilepsy; six patients had right temporal lobe epilepsy. CONCLUSION: Ictal verbal help-seeking is a rare finding among patients evaluated in epilepsy monitoring units. Ictal verbal help-seeking may suggest that seizures arise in or propagate to the right temporal lobe

Investigating the Semantic Relationships of Numerical and Minor Dependencies in Bidel Dehlavi's Poetr

Abstract At the level of the form of the poems of Bidel Dehlavi, various elements of language have been misunderstood and led to de-familiarity. "Numerical affinities" are among the most important elements that make it difficult to get meaning. Numerical affinities are words that, in the context of the language of the conjunction, when exerted by a few semantic relationships, are derived from the normal and standard norms of the language. In ordinary language, numerical affinities are words that denote by size, weight, number, area, type, gender, quantity, and form of a few, and are placed after the number in the locus of the language. Such as "two volumes of books". In poetic language, grammatical numerical affinities are just as normal, but in terms of the semantic associative system they act beyond the normal language, which is why they are known as special numerical affinities. Also, in poetic language, affiliates do not accurately state the size; for example, in the phrase "a mirror of the heart", the "mirror" like "bottle and kilo" cannot reflect on the amount and size of the heart. This ambiguity doubles when it is affiliated, and the few are both abstract, such as: "A hundred crazy madness" . Numerical affinities are one of the highlighting and ambiguous factors in the language of Bidel Dehlavi's poetry that has led the language to persuade and make it difficult to get meaning. Numerical affinities, such as: One hundred doomsday songs, one hundred strokes of madness and ... are affiliations that have crystallized in Biddle's poems, with a high frequency and with different structures than in other periods. Considering the necessity of knotting the sadness in the language of Biddle's poetry, the present study, with the help of a scientific study of particular numerical affiliations, attempts to resolve some of the tongues to a degree and to explain the relationship between the dependent and the few in terms of meaning rather than the valve To enter the poet's mind and thought, and also to get the meaning of numerical affinities and meaning of poetry. In this paper, the semantic relations of certain numerical and limited affinities in the language of Biddle's poetry have been explored and analyzed with respect to semantic normality. In semantic normality, the constituent elements of the sentence in the associative axis, and at the level of meaning, diverge from the semantic constraints and rules governing the normative language, and the language becomes prominent. "The domain of meaning as the most flexible level of language is used more than literary highlighting more than other levels of language" (Safavi, 2011, 1: 55). The particular affinities in Biddle's poems are initially in four patterns: the number, the material and material dependence, the number, the material affiliation and the few abstract, the number, the abstract dependence, and the few material, and the number, abstract, and abstract dependence, Classified, then the types of semantic relations are expressed separately in each pattern. The result of the research suggests that there is a variety of semantic relations in the fourteenth structure of the poetry of Bidel Dehwali in the axis of affinity between a number and a few. The semantic relationships in the structure of the "number, material affiliation, and material possessions" are: "the dish", such as: "One hundred grass of tulips and flowers"; "likeness", such as: "One hundred eyelashes"; "contradictions", such as: "One hundred storms of dust"; "necessity", such as: "One hundred caravans"; "tools", such as: "a swarm of swim"; "time", such as: "One hundred storms of sorrow," "kind", such as: "Thousand colors of sound "and "Creation" such as: "A breath of sting. "  In the structure of the "number, material affiliation, and abstract", there are these relationships: "dish", such as: "One hundred depressions of madness"; "metaphorical terms", such as: "a dignified enamel"; "likeness", like "half "Tools", such as "one stepping stone"; "time", such as: "One hundred salt on the liver"; "necessity", such as: "a world of belonging"; "type", such as: "One hundred colors of sorrow"; "Creation", such as: "Thousands of Chinese behavior" and "Descriptive", such as: "A hundred storm earthquakes."  The structure of the "number, abstract, and abstract", which has long-lasting and twisted relations, has these semantic relationships: "likeness", such as: "One hundred Armies of Resurrection"; "Contradictions"; "Required", such as: "One Khalid Halot" ;" Tools", such as:" A footprint"; "Time", such as "100 Spring of Presence", "Creation", such as "100 Hot Shock, "Descriptive", such as: "One Deathly Armageddon"; and "Accompaniment" such as: "One Hundred Thorns ". In the structure of the "number, abstract dependence and a few material", there are the following relationships: "likeness", such as "Several repentance"; "necessity", such as: "a pounding spontaneous"; "time", such as: "a moment Bubble "and" Creation", such as: "One hundred Melancholy". Some affiliations have a rhetorical semantic relation with a few, that is, these relations are justified in terms of literature (rhetoric), not linguistics, such as the similarity and metaphorical relationship.  This research also indicates that Bidel Dehlavi did not use any affiliate with the few freely and arbitrarily. In numerical affiliations such as: "a desert of madness", "a mirror of astonishment" and "a prostration", and ... a deliberate poet and consciousness, to create more imagination and express a particular thought, dependents has chosen

Legal foundations of lawful government, sovereignty, and state in the Islamic Republic of Iran

Abstract: This paper aims to introduce the theories on emergence of concepts like government, sovereignty, and state and analyze the foundations of constitution and the bases of other evolutionary laws. The state can find consistency and durability within the sovereignty and government of law. Foundation of the government, sovereignty, and state in the Islamic Republic of Iran complies with the theory of "God's dominion over the world and human" which is forms the basis of Islam. This also determines the responsibility, scope of duties, and civil tasks of the state. According to the Forty-Forth Article of Constitution of the Islamic Republic of Iran, Iran's economic and social systems can function in public, cooperative, and private sectors. So, lawful government, sovereignty, and state will have their own independent identity based on legal foundations

Организация и ведение аварийно-спасательных работ при наводнении на акваториях

В данной статье представлена необходимость использования эвакуации населения, исторических и материальных средств при возникновении чрезвычайных ситуаций, как одного из основных способов защиты. Основные особенности организации эвакуации, порядок ее осуществления и принципы руководства.This article presents the need to use the evacuation of the population, historical and material assets in the event of emergencies, as one of the main ways of protection. The main features of the evacuation organization, the procedure for its implementation and the principles of leadership

Thyroid Function Tests and the Serum Levels of Prolactin in Women With Suicide Attempt

Background: Suicide is a major public health concern across the world. Based on related studies, thyroid dysfunction is associated with psychiatric disorders. This study aimed to determine the relationship between thyroid function tests and serum prolactin in women with suicide attempt.Methods: A total of 261 women with the suicide attempt were included in this descriptive-analytical study which took over one year (July 2015- July 2016). In addition, the patients’ serum Thyroid-Stimulating Hormone (TSH), free T4, and prolactin were measured, too.Results: Of 261 patients, 44(16.9%) had subclinical hypothyroidism, 3(1.1%) clinical hypothyroidism, and 1(0.4%) hyperthyroidism. The median value of serum prolactin in the patients with decreased thyroid function was higher. There were not significant relationship between suicide attempts and thyroid dysfunction or serum level of prolactin.Conclusion: Although there was no significant relationship between thyroid test, serum level of prolactin and suicide attempts, the prevalence of thyroid dysfunction and high serum levels of prolactin were clinically significant in women who attempted suicide. Thus, the measurement of serum TSH, free T4 and serum levels of prolactin could be considered for these patients

Volumetric Assessment of Extratemporal Structures in Patients With Temporal Lobe Epilepsy

Background: We assessed the presence of brain volume loss in the extratemporal structures in patients with temporal lobe epilepsy (TLE). The associations between brain volume loss in these structures and epilepsy duration, magnetic resonance imaging (MRI) findings, and occurrence of focal to bilateral tonic-clonic seizures (TCS) were assessed. Methods: In this cross-sectional study, all adult patients with drug-resistant TLE, who were admitted to the epilepsy monitoring unit at Loghman-Hakim Hospital, Tehran, Iran, during 2016-2020, were included. For all the participants, brain MRI was performed and patients with TLE were divided into two subgroups of those with hippocampal sclerosis (TLE-HS) and patients with normal-appearing brain MRI findings (TLE-no). Independent sample t test was applied to compare quantitative variables in the study groups. Pearson correlation test examined the correlation between the clinical and volumetric features. Results: 203 participants (81 patients with TLE and 122 healthy controls) were studied. Compared with healthy controls, patients with TLE showed a decrease in their midbrain (P = 0.02) and thalamus (P = 0.01) volume. The degree of thalamic atrophy was more significant in TLE-HS (P = 0.03). Moreover, the degree of midbrain volume loss was more significant (P = 0.07) in patients who had TCS in the past two years (N = 31) compared with those who did not (N = 50). The volume of the thalamus (r: -0.252, P = 0.02) and pallidum (r: -0.255, P = 0.02) had inverse correlations with the epilepsy duration. Conclusion: Patients with TLE have lower midbrain and thalamus volume compared with the healthy controls, which may be attributed to the seizure-induced injury. Midbrain atrophy may theoretically increase the risk of sudden unexpected death in epilepsy (SUDEP) because of the enhanced autonomic dysfunction

Influenza vaccination coverage and obstacles in healthcare workers (HCWs) and the follow up of side effects: A multicenter investigation in Iran

Introduction. Influenza is a highly contagious acute respiratory illness. Due to the high exposure of hospital personnel, widespread vaccination of these high-risk groups seems to be a necessity in healthcare centers. To determine vaccination coverage in the personnel of four tertiary referral collegiate hospitals in 2019, and to further investigate individual obstacles for Influenza vaccination. Methods. In this cross-sectional descriptive study, 637 personnel were selected randomly from distinctive hospitals in a list-wised. Ones vaccinated filled the side effects questionnaire and who not vaccinated filled the vaccination obstacles questionnaire. Results. The mean vaccination coverage was 29.4% and the coverage difference among centers was not statistically significant (p=0.192). The following items had the most impact on personnel decision: confidence about one’s immune system (p<0.05), the experience of side effects from previous vaccinations (p=0.011), attitude about vaccination in colleagues (p=0.021) and work experience (p<0.05). About 23% of vaccinated individuals reported side effects following vaccination and the most common side effect was mild cold symptoms with 12.3% prevalence. Conclusion. The results of the current study revealed that influenza vaccination coverage among HCWs is not satisfactory in Iran. Hospital authorities and infection control units should plan to remove the obstacles of influenza vaccination